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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirteen preterm infants (median gestational age 28 weeks) who had developed neonatal chronic lung disease (CLD) and 13 gender- and gestational age-matched controls (without CLD) were prospectively followed. The infants were seen at monthly intervals for 6 months. At each attendance the infants were examined and their blood pressure (BP) measured using a noninvasive Doppler technique. No infant developed symptoms related to hypertension and there were no significant differences in their BP levels at follow up. Our results suggests significant BP elevation is uncommon following neonatal CLD.
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PMID:Effect of chronic lung disease on blood pressure levels at follow up. 833 22

We describe the clinical, radiologic, functional, and pulmonary hemodynamic characteristics of a group of 30 nonsmoking patients with a lung disease that may be related to intense, long-standing indoor wood-smoke exposure. The endoscopic and some of the pathologic findings are also presented. Intense and prolonged wood-smoke inhalation may produce a chronic pulmonary disease that is similar in many aspects to other forms of inorganic dust-exposure interstitial lung disease. It affects mostly country women in their 60s, and severe dyspnea and cough are the outstanding complaints. The chest roentgenograms show a diffuse, bilateral, reticulonodular pattern, combined with normalized or hyperinflated lungs, as well as indirect signs of pulmonary arterial hypertension (PAH). On the pulmonary function test the patients show a mixed restrictive-obstructive pattern with severe hypoxemia and variable degrees of hypercapnia. Endoscopic findings are those of acute and chronic bronchitis and intense anthracotic staining of the airways appears to be quite characteristic. Fibrous and inflammatory focal thickening of the alveolar septa as well as diffuse parenchymal anthracotic deposits are the most prominent pathologic findings, although inflammatory changes of the bronchial epithelium are also present. The patients had severe PAH in which, as in other chronic lung diseases, chronic alveolar hypoxia may play the main pathogenetic role. However, PAH in wood-smoke inhalation-associated lung disease (WSIALD) appears to be more severe than in other forms of interstitial lung disease and tobacco-related COPD. The patients we studied are a selected group and they may represent one end of the spectrum of the WSIALD.
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PMID:Pulmonary arterial hypertension and cor pulmonale associated with chronic domestic woodsmoke inhalation. 841 64

Certainty of a diagnosis is not only important for the patient but also for morbidity studies. In the absence of a gold standard, agreement with diagnostic criteria is often the best approach in measuring the certainty of a diagnosis. The agreement with diagnostic criteria has been studied for 5 chronic diseases (hypertension, chronic ischemic heart disease, diabetes mellitus, chronic nonspecific lung disease and osteoarthritis) in 7 general practices with a total practice population of 23,534 persons. Agreement with diagnostic criteria is operationalized into 3 categories. For each chronic disease a diagnostic quality measure per general practitioner is computed. Retrospective data have been collected in the practices on 2295 diseases in 1989 patients. Two-thirds of the diagnoses were made in general practice. The agreement with the diagnostic criteria for the cases diagnosed in general practice is high, ranging from 96% true positive cases in diabetes mellitus to 58% in chronic nonspecific lung disease. The highest rate of false positive cases is 4%. On the level of general practitioners diagnostic qualities vary from 62 to 96% true positive cases for the different diseases. The variation in diagnostic quality between general practitioners is substantial. The prevalence rates for the 5 chronic diseases are lower after adjustment by only including true positive cases. Diagnoses of the 5 chronic diseases recorded in general practice are generally valid with low numbers of false positive cases.
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PMID:Validity of diagnoses of chronic diseases in general practice. The application of diagnostic criteria. 850 72

With the increasing number of elderly people in The Netherlands the prevalence of chronic diseases will rise in the next decades. It is recognized in general practice that many older patients suffer from more than one chronic disease (comorbidity). The aim of this study is to describe the extent of comorbidity for the following diseases: hypertension, chronic ischemic heart disease, diabetes mellitus, chronic nonspecific lung disease, osteoarthritis. In a general practice population of 23,534 persons, 1989 patients have been identified with one or more chronic diseases. Only diseases in agreement with diagnostic criteria were included. In persons of 65 and older 23% suffer from one or more of the chronic diseases under study. Within this group 15% suffer from more than one of the chronic diseases. Osteoarthritis and diabetes mellitus are the diseases with the highest rate of comorbidity. Comorbidity restricts the external validity of results from single-disease intervention studies and complicates the organization of care.
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PMID:Comorbidity of chronic diseases in general practice. 850 73

The clinical course of 87 infants with bronchopulmonary dysplasia (BPD) on home oxygen therapy was reviewed to determine the occurrence of systemic hypertension (HTN) and to evaluate associated clinical features. Eleven of 87 (13%) infants developed systemic HTN either in the neonatal intensive care unit or following discharge. Clinical features that distinguished the hypertensive from the normotensive group were as follows: greater use of bronchodilators, 91% vs 37% (p < 0.001), and diuretics, 91% vs 55% (p < 0.05), longer duration of home oxygen therapy 21.6 +/- 9.9 vs 9.2 +/- 5.8 months (p < 0.05), and greater mortality, 36% vs 1% (p < 0.001). The course of systemic HTN in the surviving patients (7 of 11) was benign and resolved in all patients prior to weaning from home oxygen therapy. Systemic HTN is frequently present in infants with severe BPD and appears to be related to the clinical severity of lung disease.
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PMID:Systemic hypertension in infants with severe bronchopulmonary dysplasia: associated clinical factors. 851 10

Organs were donated by a small number of relatives (54/146=37%), genetically related or familial, who volunteered to give a kidney to a relative or spouse at our institution in 1991-1994. The most common reason for not accepting them was an immunological incompatibility (30 cases), followed by a diagnosis of hypertension and/or renal disease (24 cases). Other medical contraindications-including heart/lung disease, obesity, latent diabetes, and hepatic disease-were found in 14 potential donors. One woman (22 years of age) was judged too young for donation. Five ESRD patients died before the investigation of the donor had been completed. Eighteen potential donors changed their minds and decided not to donate a kidney. Interestingly, there was a high percentage of denial of spouses due to positive crossmatches.
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PMID:Reasons for not accepting living kidney donors. 861 Apr 28

This article presents recent data on several environmental toxins: lead, carbon disulfide, asbestos, arsenic, ozone, cadmium, vinyl chloride, fluorocarbons, freon, and pesticides. These environmental toxins produce both hypertension and cardiac arrhythmias in most studies, and they are not necessarily related to primary lung disease and secondary heart disease. The possible mechanisms that could cause the cardiovascular diseases include (1) damage to the endothelial barrier in the vascular system, (2) activation of leukocytes and platelets, (3) initiation of plaque formation, (4) stimulation of the inflammatory response, (5) kidney-related hypertension, and (6) direct damage to cardiac and blood vessel tissue. Recommendations are that more animal, human cultured cell, and epidemiologic studies should be conducted on the environmental toxins identified in this article.
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PMID:Cardiovascular effects of environmental chemicals. 863 34

Beclomethasone dipropionate administered by metered-dose inhaler to ventilated infants with early chronic lung disease was evaluated in a double-blind, placebo-controlled study to determine the feasibility and safety of administration. Patients selected for study were less than 1500 g birthweight, had previous radiographic evidence of respiratory distress syndrome with early changes of bronchopulmonary dysplasia (BPD), were greater than 2 weeks of age, and had failed attempts at extubation. The metered-dose inhaler was connected to the respirator circuit by an in-line spacer device and either saline placebo or beclomethasone was delivered for 7 days or until extubated. Beclomethasone was delivered in a dose calculated to be approximately 1 mg/kg/day in three divided doses. Nineteen infants were enrolled. Nine received placebo and 10 received beclomethasone. No adverse effects on blood pressure, heart rate, respiratory rate, ventilator settings, concentration or duration of oxygen therapy, incidence of retinopathy of prematurity (ROP) or infections, blood glucose, daily weight, or serum cortisol levels before and after adrenal stimulation tests were observed in the beclomethasone group compared with the placebo group. One infant in the placebo and six infants in the steroid group were extubated during the study period (p = 0.03). These data indicate that beclomethasone dipropionate may be administered safely to intubated neonates without adverse effects of hypertension, hyperglycemia, diminished weight gain, or adrenal suppression frequently seen with systemic steroid administration. Beclomethasone may enhance extubation in infants with early BPD, however, further data are required to substantiate this preliminary observation.
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PMID:Trial of beclomethasone dipropionate by metered-dose inhaler in ventilator-dependent neonates less than 1500 grams. 864 87

Central venous catheter (CVC)-related thrombus formation has been increasingly recognized as a complication in adults and somewhat less frequently in children and neonates. However, the association of CVC thrombus and pulmonary embolism (PE) has rarely been reported in infants or children, and the few existing reports primarily involve chronic, indwelling CVCs such as Broviac or Hickman catheters. During an 18-month-period of autopsy review, we found that 5 of our pediatric intensive care unit patients had autopsy-proven CVC thrombus and pulmonary embolism. All of them had prolonged mechanical ventilation for respiratory failure and required insertion of one or more short-term, temporary CVCs during the course of routine critical care management. In retrospect, signs related to CVC thrombus were present in 4 patients (3 had positive blood cultures and 1 had persistent hypertension). PE was not diagnosed until autopsy in every case. The diagnosis may have been missed because the symptoms of PE are the same as those of severe lung disease. We, therefore, advocate a heightened suspicion of CVC thrombus formation and PE in critically ill children with respiratory failure and temporary CVCs and recommend early diagnostic ultrasound to confirm the diagnosis. Once a CVC thrombus is found, subsequent pulmonary deterioration may necessitate evaluation for acute PE.
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PMID:Venous catheter thrombus formation and pulmonary embolism in children. 864 12

Recipient vessels from the head and neck region were histologically examined in 30 patients who had undergone extensive tumor resection necessitating microvascular tissue reconstruction. Past illnesses considered to be risk factors included hypertension, myocardial disease, lung disease, cirrhosis, diabetes, nephritis, as well as extensive nicotine and alcohol abuse. Blood vessels chosen for microsurgical anastomosis were exclusively examined histologically in this study. Patients undergoing microvascular surgery demonstrated vessel abnormalities in 93%. The frequency of dysplasia was higher in the arteries than in the veins (73% and 26%, respectively). Marked thickening of the blood vessel wall and severe exfoliation of the endothelial cells were observed in most arteries. Fibrodysplasia and exfoliated endothelial cells were more frequently observed in the recipient arteries than the graft arteries. Only slight thickening of the vessel wall and mild fibrodysplasia were seen in the veins. Two graft failures were correlated to technical errors rather than pre-existing vessel lesions. This study revealed that most patients undergoing microsurgery in the head and neck region demonstrate pre-existing damage in vessels, which generally hinders anastomosis. Although the study tried to identify fully the interrelationships between the extent of dysplasia, past medical history, preoperative therapy, risk factors and factors that cause free-graft failure, pre-existing changes in the recipient and graft vessels may cause technical difficulties and must be regarded as additional factors contributing to graft failure.
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PMID:Histological changes in vessels used for microvascular reconstruction in the head and neck. 870 38


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